ABSTRACT
This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in Hanwoo.Hyponatremia, hypochloremia, azotemia, and hyperglycemia were observed in both urethral obstruction and urinary bladder rupture. However, cattle with urethral obstruction showed hyperkalemia and mild hyperglycemia, whereas cattle with bladder rupture showed marked hyperglycemia and normal potassium levels. In ultrasonography, the urethral obstruction showed a dilated bladder with a thick bladder wall. In contrast to previous literature, in this study, severe electrolyte changes such as severe hyponatremia, hypochloremia, and hyperkalemia occurred in a case of complete urethral obstruction.
ABSTRACT
Sweet syndrome is a disorder characterized by painful, erythematous, cutaneous plaques and nodules of rapid onset accompanied by fever, leukocytosis, and neutrophilia. We encountered a case of a recurrent histiocytoid Sweet syndrome in a patient with acute myeloid leukemia (AML). A 64-year-old Korean man was diagnosed with complete remission of AML and had symptomatic nodules and plaques on the dorsal sides of both hands. Approximately 3 years prior, he also had symptomatic plaques at the same site and had been diagnosed with MDS (Myelodysplastic syndrome). We performed a biopsy and diagnosed this case as a malignancy-associated histiocytoid Sweet syndrome. Most Sweet syndrome cases are acute; in contrast, this case was chronic with a relapse. In addition, histopathologic examination showed a dense histiocytic infiltration. These histiocytoid cells are usually misinterpreted as histiocytes; however, they are actually immature myeloid cells. Herein, we report a case of a recurrent malignancy-associated histiocytoid Sweet syndrome in a patient with a hematologic disorder.
Subject(s)
Humans , Middle Aged , Biopsy , Fever , Hand , Histiocytes , Leukemia, Myeloid, Acute , Leukocytosis , Myeloid Cells , Recurrence , Sweet SyndromeABSTRACT
BACKGROUND: Alopecia areata (AA) is a T cell-mediated autoimmune disease that targets hair follicles and interrupts hair regrowth. The microenvironment of the effector T cells and their related cytokines may affect immunopathogenesis around the hair bulb/bulge. OBJECTIVE: To determine the contributory roles of the effector T cell subsets and related cytokines to the pathogenesis of AA. METHODS: We investigated the correlation between histopathological grades and four clinical prognostic factors in 331 patients with AA, and analyzed the topography of T cell infiltrates and related cytokines around the hair bulb/bulge according to histopathological grades through immunohistochemical and double immunofluorescence studies on a subset of AA specimens. RESULTS: First, the groups with more severe histopathological grades were associated with earlier onset, longer duration, more hair loss, as well as poorer therapeutic outcomes. Second, the pattern of CD4 and CD8 expression around the hair bulb/bulge varied by histopathological grade, with staining density decreasing in the following order: type 1>type 2>type 3. In addition, interferon-γ and transforming growth factor-β1 expression appeared denser in the peribulbar area. Interestingly, the denser CCR6⁺ cells (Th17 cells) showed more infiltration than CCR5⁺ cells (Th1 cells) around the hair bulb/bulge as histopathological grade worsened. CONCLUSION: The insidious destruction of bulge stem cells and hair bulb matrix stem cells results in more severe hair loss in patients with chronic AA, which is mediated by Th17 lymphocyte and cytotoxic T lymphocyte infiltration. Furthermore, Th17 lymphocytes may play an even more important role than cytotoxic T cells in the development of AA.
Subject(s)
Humans , Alopecia Areata , Alopecia , Autoimmune Diseases , Cytokines , Fluorescent Antibody Technique , Hair Follicle , Hair , Lymphocytes , Stem Cells , T-Lymphocyte Subsets , T-Lymphocytes , Th17 CellsABSTRACT
Pyoderma gangrenosum (PG) is rare chronic painful ulcerative skin disorder usually associated with various systemic diseases, the most common of which is inflammatory bowel disease (IBD). PG shows a particularly stronger correlation with ulcerative colitis than Crohn's disease. It generally occurs at sites of trauma (pathergy), butspontaneous lesions with no evident trauma are not uncommon. PG is classified into four major clinical types: ulcerative, pustular, bullous, and vegetating. The ulcerative type is mostly associated with IBD. On the other hand, the bullous type is known to be associated with lymphoproliferative disorders. We report a rare case of PG of the bullous types forming multiple lesions on the face of a 21-year-old Korean woman with ulcerative colitis.
Subject(s)
Female , Humans , Young Adult , Chronic Pain , Colitis, Ulcerative , Crohn Disease , Hand , Inflammatory Bowel Diseases , Lymphoproliferative Disorders , Pyoderma Gangrenosum , Pyoderma , Skin , UlcerABSTRACT
PURPOSE: The aim of this study was to determine the prevalence of diabetes in patients with random serum glucose over 200 mg/dL in an emergency department. METHODS: A retrospective descriptive pilot study was conducted using chart review of patients who have visited the ED at Kangdong Sacred Heart Hospital. Between April and October 2014, patients aged 18 years and older with random serum glucose level higher than 200 mg/dL and having no prior diabetes mellitus (DM) were enrolled. Regardless of the patient's chief complaint, a history of current symptoms related to diabetes of patients was obtained and additional serum HbA1c was measured. The follow-up test was recommended on endocrinology OPD or the inpatient ward. Patients' medical records regarding diagnosis of DM were reviewed. RESULTS: A total of 296 patients with random serum glucose level estimated above 200 mg/dL without previous DM history were enrolled in this study, however only 82 patients were eligible. Among them, 34 patients (41.4%) were newly diagnosed as DM; 38 patients had current presumptive symptoms of diabetes while 44 patients had none of those symptoms. Twenty three patients (60.5%) with presumptive diabetes symptoms were diagnosed as diabetes while another 15 patients (39.5%) were not. Eleven (25.0%) patients without symptoms of diabetes were diagnosed as diabetes while 33 patients (75.0%) were not. The difference between two groups was significant. (p=0.001) CONCLUSION: The prevalence of undiagnosed DM patients in patients with random serum glucose level over 200 mg/dL in the emergency department was considerably high. Therefore emergency physicians should pay attention to opportunistic hyperglycemia and active diabetes screening.
Subject(s)
Humans , Blood Glucose , Diabetes Mellitus , Diagnosis , Emergencies , Emergency Medicine , Emergency Service, Hospital , Endocrinology , Follow-Up Studies , Heart , Hyperglycemia , Inpatients , Korea , Mass Screening , Medical Records , Pilot Projects , Prevalence , Retrospective StudiesABSTRACT
No abstract available.
Subject(s)
Humans , Colon , Colonic Neoplasms , Sparganosis , UltrasonographyABSTRACT
BACKGROUND: In the treatment of vitiligo, topical corticosteroids are known to be effective, but are associated with serious adverse effects. Many studies have shown that topical calcipotriol is a promising therapeutic modality in vitiligo. In some studies, combined calcipotriol and betamethasone dipropionate ointment has been shown to be a more effective and well tolerated treatment for vitiligo. The combination therapy seems to synergistically act as an immunosuppressive and a pigment restorative agent. OBJECTIVE: We investigated the clinical efficacy of CCB (Combination Calcipotriol and Betamethasone dipropionate) gel compared with that of betamethasone dipropionate alone in the repigmentation of vitiligo. METHODS: In an intraindividual right-left comparison study (n=20), a CCB gel was applied once daily to a lesion on one side, and betamethasone dipropionate cream was applied to a lesion on the other side. The degree of repigmentation was assessed according to the Vitiligo Area Scoring Index (VASI) at baseline, 4, 12, 24, and 48 weeks. RESULTS: The CCB gel treated group showed a remarkably improved therapeutic outcome compared to the betamethasone dipropionate monotherapy group: the percentages of VASI relative to the baseline at CCB gel treated sites were 82.73+/-8.17%, 70.45+/-14.05%, 62.73+/-17.52%, and 56.24+/-18.49% at 4, 12, 24, and 48 weeks after treatment, respectively; while those of the other sites receiving betamethasone dipropionate were 89.55+/-7.24%, 84.55+/-10.60%, 77.73+/-14.38%, and 73.48+/-12.93%. Adverse effects such as atrophy and burning sensations were much less after CCB gel treatment than after betamethasone monotherapy. CONCLUSION: CCB gel is more effective and tolerable than betamethasone dipropionate monotherapy in repigmentation therapy for vitiligo.
Subject(s)
Adrenal Cortex Hormones , Atrophy , Betamethasone , Burns , Sensation , VitiligoABSTRACT
Mastocytosis is characterized by an accumulation of mast cells in various organs, most frequently in the skin. A solitary mastocytoma is a clinical variant of cutaneous mastocytosis. It is defined as a localized collection of mast cells in the skin without evidence of extracutaneous organ involvement. Here we report on a 2-year-old female patient presenting with Solitary erythematous bulla on her lower back. The patient had a history of spinal tap on the lower back for evaluation of meningitis at 5 months of age, which resulted in trauma at the site. Histopathology showed mast cells infiltrating the papillary and reticular dermis and metachromatic purple cytoplasmic granules seen with Giemsa staining. As a result, the patient was diagnosed with a solitary bullous mastocytoma and administered antihistamine. The patient showed complete remission at 3 months. Herein, we report a rare case of solitary bullous mastocytoma occurring at a trauma site.
Subject(s)
Child, Preschool , Female , Humans , Azure Stains , Cytoplasmic Granules , Dermis , Mast Cells , Mastocytoma , Mastocytosis , Mastocytosis, Cutaneous , Meningitis , Skin , Spinal PunctureABSTRACT
Palisaded neutrophilic and granulomatous dermatitis (PNGD) is characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. It has been associated with multiple systemic diseases, particularly autoimmune conditions like rheumatoid arthritis and Behcet's disease. We report a 52-year-old woman with rheumatoid arthritis who presented with a single, non-tender, rapidly growing nodule on her right elbow. Histologic examination of the nodule revealed degenerated collagen, neutrophils, neutrophilic dust, fibrin, and mucin present in the centers of the palisades of histiocytes throughout the dermis. Herein, we report the abrupt onset of PNGD in a patient with rheumatoid arthritis.
Subject(s)
Female , Humans , Middle Aged , Arthritis, Rheumatoid , Collagen , Dermatitis , Dermis , Dust , Elbow , Fibrin , Histiocytes , Inflammation , Mucins , Neutrophils , VasculitisABSTRACT
BACKGROUND: The incidence of cutaneous malignant tumors, especially basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM), has continuously increased in Korea. However, there has been little research into the distribution and incidence of malignant skin tumors in the south-eastern part of Korea. OBJECTIVE: The purpose of this study was to analyze recent trends in incidence and clinical patterns of cutaneous malignant tumors in Busan city and the eastern Gyeongnam Province. METHODS: We reviewed 714 cases of cutaneous malignant tumors that include BCC, SCC, and MM from January 1996 to December 2010 at the Department of Dermatology in Dong-A University Hospital. RESULTS: The average annual incidence of cutaneous malignant tumors among the total number of outpatients was 1.18% and has continuously increased from 0.63% to 1.91% over the last 15 years (1996~2010). In particular, the average annual incidence of BCC and SCC has markedly increased from 0.35% and 0.25% to 0.94% and 0.79%, respectively. The most common cutaneous malignant tumor was BCC (48.32%), followed by SCC (41.18%) and MM (10.50%). The mean age of onset in patients who had been diagnosed with cutaneous malignant tumors was 65.07 years (males: 62.04, females: 67.87). There was a similar incidence between males and females in cutaneous malignant tumors (1:1.08). The most common site of cutaneous malignant tumors was the face (66.25%); the cheek (34.04%) was the most preferential site on the face, followed by the nose (30.23%). CONCLUSION: The incidence of cutaneous malignant tumors has gradually increased in Busan city and the eastern Gyeongnam Province, which was relatively higher than the incidence in other areas. It was thought to be due to the higher proportion of the elderly than in other areas of the country and skin cancer centers in our hospital.
Subject(s)
Aged , Female , Humans , Male , Age of Onset , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cheek , Dermatology , Incidence , Korea , Melanoma , Nose , Outpatients , Skin , Skin Neoplasms , Statistics as TopicABSTRACT
The other generalized type of epidermolysis bullosa simplex (EBS) is a genetic blistering skin disease, caused by a mutation of the genes encoding keratin 5 and 14. EBS starts at birth and is characterized by generalized blisters following a minor trauma that heals with hyperpigmentation. A 19-year-old man presented with 19-year history of multiple erythematous vesicles in a herpetiform arrangement on the trunk, axilla, and thigh with post-inflammatory hyper-pigmentations. On light and electron microscopy, the biopsy specimen showed intraepidermal blisters that formed within the basal keratinocyte. The serum from a patient with bullous pemphigoid antibody and laminin 5 antibody showed the linear deposition at the floor of the blister on immunofluorescence mapping study. On the basis of our clinical, microscopic, and immunofluorescence findings, we diagnosed the patient as having a generalized type of EBS. Herein, we report on an interesting case of the other generalized type of EBS.
Subject(s)
Humans , Axilla , Biopsy , Blister , Cell Adhesion Molecules , Epidermolysis Bullosa , Epidermolysis Bullosa Simplex , Floors and Floorcoverings , Fluorescent Antibody Technique , Hyperpigmentation , Keratin-5 , Keratinocytes , Laminin , Light , Methylmethacrylates , Microscopy, Electron , Parturition , Pemphigoid, Bullous , Polystyrenes , Skin Diseases , ThighABSTRACT
PURPOSE: The butterfly-shaped pigment dystrophy is an extremely rare autosomal dominant retinal disorder. The authors present a case of butterfly-shaped pigment dsytrophy not reported previously in Korea. CASE SUMMARY: A 45-year-old man had bilateral blurred vision for 2 years. His visual acuity was 0.2 in the right eye, and 0.3 in the left and was uncorrected. Funduscopically, yellow pigment deposits were present at the level of retinal pigment epithelium (RPE) in the central macula of both eyes. Fluorescein angiography (FA) revealed a central, dark, butterfly-shaped lesion surrounded by a region of hyperfluorescence, Spectral domain optical coherence tomography (OCT) showed thick elevation of the RPE with hyperreflectivity and disruption of the inner and outer segment (IS/OS) interface of the photoreceptors. The patient had normal color vision, visual field and electroretinograms and reduced electrooculograms. CONCLUSIONS: In general, butterfly-shaped pigment dystrophy is known to have good visual prognosis. However, in some cases the disease can be a chronic progressive disorder with secondary involvement of the photoreceptors, as exemplified this patient. The authors anticipate more detail regarding the natural course of this disease will be obtained through spectral domain OCT.
